PHARMA CNS

The sympathetic response is ___, and the parasympathetic response is ___.

nerve fiber carries messages from the CNS to the ganglion

fiber transmits impulses from the ganglion to body tissues and organs.

which stimulates the cerebral cortex of the brain

which act on the brain stem and medulla to stimulate respiration

which are thought to supress appetite by stimulating the satiety center in the
hypothalamic and limbic areas of the brain.

Long-term use of amphetamines can produce psychological ___ and ___. conditions in which larger and larger doses of a drug are needed to reproduce the initial response.

might be caused by a dysregulation of the transmitters serotonin, norepinephrine, and dopamine.

is characterized by falling asleep during normal waking activities such as driving a car or talking with someone.

stimulate the release of neurotransmitters— norepinephrine and dopamine—from the brain and sympathetic nervous system (peripheral nerve terminals) and blocks the reuptake of these transmitter.

The half life of amphetamines usually varies from __ to __ hours.

___ and ___ classed as amphetamine- like drugs, are given to increase a child’s attention span and cognitive performance (e.g., memory, reading) and to decrease impulsiveness, hyperactivity, and restlessness.

___ is also used to treat narcolepsy.

___ is another drug prescribed for narcolepsy. It increases the amount of time patients with narcolepsy feel awake. Its mechanism of action is not fully known.

___ is the most frequently prescribed drug used to treat ADHD.

Methylphenidate should be given __hours or more before sleep, because it may cause insomnia.

cause a stimulant effect on the hypothalamic and limbic region of the brain to suppress the appetite. Most of the anorexiants used to suppress appetite do not have the serious side effects associated with amphetamines.

Children younger than __ years should not be given anorexiants, and self medication with anorexiants should be discouraged.

which are CNs stimulants, mostly affect the brain stem and spinal cord but also affect the cerebral cortex.

If these dreams are unpleasant, they may be called ___.

Two Phases of normal sleep

It is difficult to rouse a person during ___ sleep.

Sleep-walking or nightmares that occur in children take place during ___ sleep.

residual drowsiness resulting in impaired reaction time.

results in vivid dreams and nightmares, frequently occurs after taking a hypnotic for a prolonged period then abruptly stopping.

the result of chronic hypnotic use

results when there is a need to increase the dosage over time to obtain the desired effect.

reversible when the drug is discontinued

Long-term use of a hypnotic may result in CNS depression, which is characterized by lethargy, sleepiness, lack of concentration, confusion, and psychological depression.

High doses of sedative hypnotics can suppress the respiratory center in the medulla.

Skin rashes and urticaria can result when taking barbiturates. Such reactions are rare.

are commonly ordered for treatment of sleep disorders.

The mildest form of CNS depression is ___, which diminishes physical and mental responses at lower dosages of certain CNS depressants but does not affect consciousness.

Are hypnotics useful in achieving sleep, because they allow the patient to awaken early in the morning without experiencing
lingering side effects.

Are hypnotics useful for sustaining sleep; however, after using one the patient may experience residual drowsiness, or hangover, in the morning.

Were introduced as a sedative in the early 1900s

Were introduced with chloradiazepoxide in the 1960s as antianxiety agents

phenobarbital and mephobarbital and is used to control seizures in epilepsy.

such as butabarbital are useful as sleep sustainers for maintaining long periods of sleep. Because these drugs take approximately 1 hour for the onset of sleep, they are not prescribed for those who have trouble getting to sleep. Vital signs should be closely monitored in persons who take intermediate-acting barbiturates.

barbiturates secobarbital and pentobarbital are used primarily for sedation preoperatively. Vital signs should be closely monitored in persons who take short-acting barbiturates.

Barbiturates should be restricted to short-term use of __ weeks or less because of their numerous side effects, including tolerance to the drug.

This drug group is ordered as sedative-hypnotics for inducing sleep.

Increased anxiety might be the cause of insomnia for some patients, so ___ and ___ (Valium) can be used to alleviate the anxiety.

Benzodiazepines are classified as schedule __according to the Controlled Substances Act.

Benzodiazepines can suppress stage 4 of NREM sleep, which may result in vivid dreams or nightmares and can delay REM sleep except for ___

Closely associated with benzodiazepines is ___ ___- An impaired ability to recall events that occur after dosing.

is a nonbenzodiazepine that differs in chemical structure from benzodiazepines.
It is used for short term treatment (less than 10 days) of insomnia.
Its duration of action is 6 to 8 hours with a short half-life of 2 to 4.5 hours.

is in the newest category of sedative/ hypnotics, called melatonin agonists.

Ramelteon (Rozerem) is in the newest category of sedative/ hypnotics, called ___ ___.

is the first FDA-approved hypnotic that is not classified as a controlled substance. This drug acts by selectively targeting melatonin receptors to regulate circadian rhythm in the treatment of insomnia. Ramelteon has not been shown to decrease REM sleep. This new drug has a half life of 1 to 3 hours.

Anesthetics are classified as ___ and ___.

___depress the CNS, alleviate pain, and cause a loss of consciousness.

The first anesthetic, ___ ___, was used for surgery in the early 1800s. It is still an effective anesthetic and is frequently used in dental procedures and surgery.

___ ___ is a combination of drugs that are frequently used in general anesthesia.

Stages of Anesthesia

Stage of anesthesia which begins with consciousness and ends with loss of consciousness. Speech is difficult; sensations of smell and pain are lost. Dreams and auditory and visual hallucinations may occur. This stage may be called the induction stage.

Stage of anesthesia which produces a loss of consciousness caused by depression of the cerebral cortex. Short induction time.

Stage of anesthesia which surgical procedure is performed during this stage. There are four phases. The surgery is usually performed in phase 2 and upper phase 3. As anesthesia deepens, respirations become more shallow and respiratory rate is increased.

Stage of anesthesia which it is the toxic stage of anesthesia.Respirations are lost, and circulatory collapse occurs. Ventilatory assistance is necessary.

___ ___ typically provide smooth induction.

___ ___may be used for general anesthesia or for the induction stage of anesthesia. For outpatient surgery of short duration, this might be preffered form of anesthesia.

limited to mucous membranes, broken or unbroken skin surfaces, and burns. They decrease the sensitivity of nerve endings in the affected area

___ ___block pain at the site where the drug is administered by preventing conduction of nerve impulses.

useful in dental procedures, suturing skin lacerations, short term (minor) surgery at a localized area, blocking nerve impulses (nerve block) below the insertion of a spinal anesthetic, and diagnostic procedure such as lumbar puncture and thoracentesis.

The first local anesthetic used was ___ ___

___ ___, a synthetic of cocaine, was discovered in the early 1900s.

___ has a rapid onset and a long duration of action, is more stable in solution, and causes fewer hypersensitivity reactions than procaine. Since the introduction of this, many local anesthetics have been marketed.

A continuous flow of ___ a local anesthetic, is delivered via a Y-connector to both sides at a flow rate of approximately 2 mL/h.

requires that a local anesthetic be injected in the subarachnoid space below the first lumbar space (L1) in adults and the 3rd lumbar space (L3) in children.

Results from the penetration of the anesthetic into the subarachnoid space, which is the space between the pia mater membrane and the arachnoid membrane.

Is the placement of the local anesthetic in the epidural space just posterior to the spinal cord or the dura mater. The epidural is located between the posterior longitudinal ligament on the anterior side and the ligamentum flavum posteriorly.

Is an epidural block place by administering a local anesthetic through the sacral hiatus.

Is given at the lower end of the spinal column to block the perineal area. Blood pressure should be monitored during administration of these types of anesthesia because a decrease in BP resulting from the drug and procedure might occur.